Fetal Alcohol Spectrum Disorders Prevention

The Practice and Implementation Center – South (PIC-S) was established in 2014 with funding from Centers for Disease Control and Prevention. The center is based at Baylor College of Medicine’s Department of Family & Community Medicine and is dedicated to providing medical and behavioral health professionals the skills necessary to effectively prevent Fetal Alcohol Spectrum Disorders. Besides other CDC-funded practice and implementation centers, PIC-S partners with The University of Texas at Austin, the American Academy of Family Physicians, and the National Association of Social Workers to continue the work previously done by the Southeast Fetal Alcohol Spectrum Disorders Regional Training Center.

The PIC-S has faculty who are experts in the fields of family medicine, pediatrics, developmental pediatrics, preventive medicine, addiction medicine, social work, nursing, physical therapy, medical ethics and global health, including:

• Roger Zoorob, M.D., MPH, FAAFP
• Mohamad Sidani, M.D., MS
• Alicia Kowalchuk, D.O.
• Sandra Gonzalez, MSSW, Ph.D.
• Mónica Alzate, Ph.D., LCSW, MA
• Kiara Spooner, DrPH, MPH, CHES
• Luis Rustveld, Ph.D., RD, LD

FASD is an umbrella term for a group of disorders that can occur from in utero alcohol exposure. Effects may include physical abnormalities, behavioral problems, and/or difficulties learning. Often a person with an FASD has a mixture of these problems.

Cause and Prevention

• FASDs are caused by alcohol exposure in utero. There is no known safe amount of alcohol to drink while pregnant. There is also no safe time to drink during pregnancy and no safe type of alcohol to drink while pregnant.
• To prevent FASDs, a woman should not drink alcohol while she is pregnant, or during a time when she might become pregnant.

Signs and Symptoms

Alcohol exposure in utero can affect each person in different ways, and can range from mild to severe.

People with an FASD might have:

• Abnormal facial features, such as a smooth ridge between the nose and upper lip (this ridge is called the philtrum)
• Small head size
• Shorter-than-average height
• Low body weight
• Poor coordination
• Hyperactive behavior
• Difficulty paying attention
• Poor memory
• Difficulty in school (especially with math)
• Learning disabilities
• Speech and language delays
• Intellectual disability or low IQ
• Poor reasoning and judgment skills
• Sleep and sucking problems as a baby
• Vision or hearing problems
• Problems with the heart, kidneys, or bones

FASDs include Fetal Alcohol Syndrome, Alcohol-related Neurodevelopmental Disorder, Alcohol-related Birth Defects, as well as a spectrum of developmental disabilities associated with in utero alcohol exposure. Formal diagnostic criteria and ICD codes exist for FAS and ARBD.

Fetal Alcohol Syndrome
Fetal death is the most extreme outcome from in utero alcohol exposure. However, people born with FAS have abnormal facial features, growth problems, and central nervous system (CNS) problems. People with FAS can have problems with learning, memory, attention span, communication, vision, and/or hearing. People with FAS often have a hard time in school and have trouble with relationships if they are not diagnosed and do not receive needed services and accommodations for their disabilities.

Alcohol-Related Neurodevelopmental Disorder
People with ARND might have intellectual disabilities and problems with behavior and learning. They often struggle with school performance and have difficulties with math, memory, attention, judgment, and poor impulse control.

Alcohol-Related Birth Defects 
People with ARBD might have difficulty hearing or problems with the heart, kidneys, or bones. Often they have a combination of these problems.